False-positive HIV in a patient with SARS-CoV-2 infection; a case report

Rawezh Q Salih, Gasha A Salih, Berwn A Abdulla, Abdulla D Ahmed, Hawbash R Mohammed, Fahmi H Kakamad, Abdulwahid M Salih, Rawezh Q Salih, Gasha A Salih, Berwn A Abdulla, Abdulla D Ahmed, Hawbash R Mohammed, Fahmi H Kakamad, Abdulwahid M Salih

Abstract

Introduction: A small portion of Corona Virus disease-2019 (COVID-19) cases associated with co-infections, however occasionally they turn out to be false positive due to possible cross-reactivities. The current report aims to present a rare case of false-positive human immunodeficiency virus (HIV) in a COVID-19 patient.

Case report: A 32-year-old female complaining from thyroid problems referred for thyroid operation. She had mild symptoms of COVID-19. Her preoperative laboratory findings were normal, except for HIV screening test which was repetitively positive. RNA PCR was performed to confirm the diagnosis of HIV, it revealed a negative result. The patient underwent thyroidectomy as planned and was given the required supportive treatment to recover from COVID-19. Two-month follow up revealed that she was negative for COVID-19 on PCR testing, and HIV immunoassay test was no longer positive.

Discussion: Due to structural similarities between the spike protein chains of SARS-CoV-2 and some other viruses such as dengue, Zika, and other closely related coronaviruses (SARS-CoV, MERS-CoV), the protein can potentially interfere with the immunoassay tests. Although HIV immunoassay tests have high sensitivity and specificity, false-positive results have been reported, such as in the case of Epstein Barr virus, Influenza vaccination, and the Australian COVID-19 vaccination.

Conclusion: Similarity between HIV and SARS-CoV-2 spike proteins can lead to antibody cross-reactivities, yielding false-positive results on immunoassay screening tests.

Keywords: COVID-19; Cross-reactivity; False-positive; HIV; SARS-CoV-2.

Conflict of interest statement

None to be declared.

© 2021 The Authors.

References

    1. Abdullah H.M., Hama-Ali H.H., Ahmed S.N., Ali K.M., Karadakhy K.A., Mahmood S.O., et al. Severe refractory COVID-19 patients responding to convalescent plasma; A case series. Annals of medicine and surgery. 2020;56(1):125–127.
    1. Amin A.A., Awakhti A.H., Hussein L.A., Fattah F.H., Baba H.O., Kakamad F.H., et al. Survived COVID-19 patient presented with death on arrival: a case report. International Journal of Surgery Case Reports. 2021;81(1):1–3.
    1. Baram A., Kakamad F.H., Abdullah H.M., Mohammed-Saeed D.H., Hussein D.A., Mohammed S.H., et al. Large vessel thrombosis in patient with COVID-19, a case series. Annals of Medicine and Surgery. 2020;60(1):526–530.
    1. Kakamad F.H., Mahmood S.O., Rahim H.M., Abdulla B.A., Abdullah H.O., Othman S., et al. Post covid-19 invasive pulmonary Aspergillosis: a case report. International journal of surgery case reports. 2021;82(1):1–3.
    1. Ahmad Shwan A., Salih Karokh H., Ahmed Shaho F., Kakamad Fahmi H., Salh Abdulwahid M., Hassan Marwan N., et al. Post COVID-19 transverse myelitis; a case report with review of literature. Annals of Medicine and Surgery. 2021;69:1–3.
    1. Lustig Y., Keler S., Kolodny R., Ben-Tal N., Atias-Varon D., Shlush E., et al. Potential antigenic cross-reactivity between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and dengue viruses. Clin. Infect. Dis. 2020;2:1–6.
    1. Ogawa T., Fukumori T., Nishihara Y., Sekine T., Okuda N., Nishimura T., et al. Another false-positive problem for a SARS-CoV-2 antigen test in Japan. J. Clin. Virol. 2020;131(1):1.
    1. Papamanoli A., Psevdos G. False-positive HIV screening test in a patient with pulmonary embolism because of severe acute respiratory syndrome coronavirus 2 infection. AIDS. 2021;35(9):1521–1522.
    1. Agha R.A., Franchi T., Sohrabi C., Mathew G., Kerwan A., Thoma A., et al. The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int. J. Surg. 2020;84(1):226–230.
    1. Faccini-Martínez Á.A., Rivero R., Garay E., García A., Mattar S., Botero Y., et al. Serological cross-reactivity using a SARS-CoV-2 ELISA test in acute Zika virus infection, Colombia. Int. J. Infect. Dis. 2020;101(1):191–193.
    1. Tan S.S., Chew K.L., Saw S., Jureen R., Sethi S. Cross-reactivity of SARS-CoV-2 with HIV chemiluminescent assay leading to false-positive results. J. Clin. Pathol. 2020;1(1):1.
    1. Mannar D., Leopold K., Subramaniam S. Glycan reactive anti-HIV-1 antibodies bind the SARS-CoV-2 spike protein but do not block viral entry. Sci. Rep. 2021;11(1):1–9.
    1. Walls A.C., Park Y.J., Tortorici M.A., Wall A., McGuire A.T., Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181(2):281–292.
    1. Hicks J., Klumpp-Thomas C., Kalish H., Shunmugavel A., Mehalko J., Denson J.P., et al. Serologic cross-reactivity of SARS-CoV-2 with endemic and seasonal Betacoronaviruses. J. Clin. Immunol. 2021;41(1):906–913.
    1. Ssentongo P., Heilbrunn E.S., Ssentongo A.E., Advani S., Chinchilli V.M., Nunez J.J., et al. Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis. Sci. Rep. 2021;11(1):1–2.
    1. Zhang C., Zheng W., Huang X., Bell E.W., Zhou X., Zhang Y. Protein structure and sequence reanalysis of 2019-nCoV genome refutes snakes as its intermediate host and the unique similarity between its spike protein insertions and HIV-1. J. Proteome Res. 2020;19(4):1351–1360.
    1. Yamaniha K., Kinjo T., Akamine M., Setoguchi M., Tateyama M., Fujita J. False-positive for SARS-CoV-2 antigen test in a man with acute HIV infection. J. Infect. Chemother. 2021;27(7):1112–1114.
    1. Kavallierou L., Bazigou F., Cheropoulou A. Acute EBV infection and HIV antibody cross-reactivity in a first Time donor. Hematology & Transfusion International Journal. 2015;1(4):100–102.
    1. Ly T.D., Ebel A., Faucher V., Fihman V., Laperche S. Could the new HIV combined p24 antigen and antibody assays replace p24 antigen specific assays? J. Virol Methods. 2007;143(1):86–94.
    1. Erickson C.P., McNiff T., Klausner J.D. Influenza vaccination and false positive HIV results. N. Engl. J. Med. 2006;354(13):1422–1423.
    1. McIntyre P., Joo Y.J., Chiu C., Flanagan K., Macartney K. COVID-19 vaccines–are we there yet? Aust. Prescr. 2021;44(1):19–25.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa